Provider Demographics
NPI:1467880476
Name:MOVING ON RECOVERY AND EDUCATION
Entity Type:Organization
Organization Name:MOVING ON RECOVERY AND EDUCATION
Other - Org Name:M.O.R.E
Other - Org Type:Other Name
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MISS
Authorized Official - First Name:PATTI
Authorized Official - Middle Name:
Authorized Official - Last Name:NYBECK-GARCIA
Authorized Official - Suffix:
Authorized Official - Credentials:LADC
Authorized Official - Phone:507-454-2839
Mailing Address - Street 1:124 MAIN ST SE
Mailing Address - Street 2:
Mailing Address - City:PRESTON
Mailing Address - State:MN
Mailing Address - Zip Code:55965-1202
Mailing Address - Country:US
Mailing Address - Phone:507-765-2505
Mailing Address - Fax:
Practice Address - Street 1:124 MAIN ST SE
Practice Address - Street 2:
Practice Address - City:PRESTON
Practice Address - State:MN
Practice Address - Zip Code:55965-1202
Practice Address - Country:US
Practice Address - Phone:507-765-2505
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-10-30
Last Update Date:2013-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN1048350101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Single Specialty